The low back, also called lumber region, is the area of the back that starts below the rib cage. Pain in the low back can be a result of conditions affecting lumber spine, intervertebral disc (disc between the vertebrae), ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen and skin covering the lumber area.
According to the European Guidelines for prevention of low back, low back pain is defined as “Pain and discomfort, localized below the costal margin and above the inferior gluteal folds, with or without leg pain” S.Kinkade says that “pain that occurs posteriorly in the region between the lower rib margin and the proximal thighs”. The most common form of low back pain can be described as non-specific in nature. Non-specific low back pain implies that there is no specific anatomical dysfunction that can attribute to pain presentation.
Low back pain is usually categorized in 3 subtypes: acute, sub-acute and chronic low back pain. This category assists in identifying how long the pain has been present, with acute being a recent onset and chronic meaning has been present for some time. It is not uncommon to have an acute exacerbation on a chronic underlying condition. Many people who experience low back pain will report having multiple episodes of exacerbation. Other ways that individuals may describe back pain are identified below;
- Low back pain that is dull or achy in nature
- Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica)
- Muscle spasms and tightness in the low back, pelvis, and hips
- Pain that worsens after prolonged sitting or standing
- changing position is usually difficult like standing up straight, walking or going from standing to sitting.
Benefits of physiotherapy in lumbar pain:
Physiotherapy will typically be delivered in a multi-modal approach. The intervention may include both active and passive therapies as well as education on pain and self-management. The treatment that is supported by the most evidence is active Physiotherapy with education on self-management. Return to meaningful movement and individualized activities of daily living is typically the goal with intervention.
Active physiotherapy includes specific exercises and stretching. Advice for early activity is well supported.
Active Physiotherapy management is very beneficial for lumbar pain. As with any exercise program, it is important to warm up before doing exercise and cool down post exercises. Your Physiotherapist will work with you to develop an exercise program that matches your abilities, interests and goals. Your Physiotherapist will ensure that exercises are being done correctly and safely to maximize your physical function and will be there to progress as you move through the program. Exercises that may be included in your prescribed program include;
- General exercises and stretches
Properly structured exercises and stretches in the context of the patient’s individual condition
- Specific stabilization exercises
For strength and stability of back muscles
- Strengthening Exercises
To assist in the general and specific strengthening of muscles involved and improve general function
Passive physiotherapy includes interventions applied to the patients, these may include but are not limited to manual therapies, acupuncture, and modalities such as heat and cryotherapy and electrical stimulation. There is evidence to support that mobilization and manipulation can be helpful in the treatment of back pain. Some of these interventions can be prescribed to the patient so that they can engage in self-management using these strategies.
Education on Pain and Self-Management
It is important with nonspecific low back pain to appreciate that there are likely several factors that are contributing to the pain and that the pain cannot be typically resolved by ‘fixing’ one structure. Advice on early movement is important as movement will assist in improving function and symptoms. Other education may include self-pain management strategies, education to motivate movement, and advice on workplace activities and setup.
Where Can I Find a qualified Physiotherapist to treat my lower back?
You have to look no further than Physiotherapy First in Brampton to find a certified physiotherapist. Our physiotherapists receive ongoing training, education, and recertification in physiotherapy to ensure we are providing our patients access to the latest and most advanced treatments.
Physiotherapy First offers patients in Brampton and the surrounding area exceptional care with a personalized treatment plan to suit your specific needs. If you are suffering from pain or have recently experienced an injury, our Physiotherapists will ensure you get back to the activities you enjoy and love. Call us at 905-796-6662 for an appointment today or email us at info@physiotherapyfirst.ca.
